This Mid-Career Award is requested to support the continued research development and mentoring activities of Richard D. Stevenson, MD, Associate Professor of Pediatrics at the University of Virginia (UVA). Over the past 10 years, Dr. Stevenson has shown a commitment to patient-oriented research and mentoring of new investigators. He is the principal investigator of a focused research effort investigating the importance of growth, nutrition, and physical development on the health and quality of life of children with cerebral palsy (CP). The goals of this proposal for research training, mentoring, and clinical research (respectively) are to (1) transition the applicant's research program of descriptive studies that have identified problems and trends to clinical trials that will test hypotheses toward the improvement of child health, (2) provide training and mentorship in clinical research (in general) and clinical research in persons with disabilities (specifically), and (3) maximize the health, participation and quality of life of children with CP and their families through the management of growth, nutritional status and other secondary conditions. The applicant is requesting K-24 funding to devote 50% of his time toward these pursuits. The next 5 years are critical to the consolidation of the applicant's research program and the expansion of his efforts through the mentoring and training of new investigators. The research training plan has been significantly expanded with this revision in response to the last review. It includes coursework, study, and practice in the development and conduct of clinical trials in persons with disabilities. This training will be accomplished through enrollment in the Multidisciplinary Training Program in Clinical Investigation, formal coursework through UVA's Department of Health Evaluation Sciences, and through collaborative efforts with colleagues. The mentoring plan has been simplified and includes (1) development of a patient-oriented research curriculum for residents, fellows, and faculty in pediatrics, developmental medicine and rehabilitation, using all resources available at UVA, (2) focused mentoring of the new investigators with the development of individualized research plans with each mentee, and (3) mentored completion of discrete research projects by each mentee. The research plan consists of studies that are part of the North American Growth in Cerebral Palsy Project (NAGCPP), and focuses on the development of clinical trials of nutritional interventions for the treatment and prevention of malnutrition. As poor growth and malnutrition are common, and as children with CP can be considered a clinical model of individuals with disabilities at large, this work is important and highly relevant to populations of children and adults with developmental and acquired disabilities.